In order to offer Holistic Health Care, one very important gradient is a good doctor-patient relationship. Proper healing can take place only if the patient has confidence and faith in the ability of the doctor. Mr.Mukesh Shah, a 48 year old bank officer came to consult me for his chronic borderline Schizophrenia. He had consulted a senior psychiatrist for his problem. While narrating his past treatments he said, " The senior psychiatrist was not ready to listen to my full history, I doubt whether he understood my problems." If patients develop such impression, then even though the doctor gives the right medicine it will not have the desired effect on the physiological system of the patient. Due to this sense of doubt in the patients mind, negative signals will be given to the bodily organs which will prevent the positive effects of the medicine.
The patients state of mind has an all round effect on all systems of his body, hence positive expectation on the part of the patient plays the pivotal role in the healing processes.
In this chapter nine simple and practical points are described which can easily be adapted by doctors for enhancing better relationship with patients.
Address Patient By First Name
Most frequently it is observed that in hospitals and private practice the patients are addressed by their diseases, bed numbers, etc. While taking rounds a junior doctor may say, "This is a chronic nephritis, this is cirrhosis of liver, this is thyroid goitre and so on. When doctors identify patients in this manner i.e. only by the disease, we completely tend to neglect many other aspects of the patient's personality, environmental influences, life styles, etc., which are significant while offering Holistic Health Care. Unintentionally, while adopting such a mechanical approach we may adversely affect the patients mind. In a civil hospital of a big city, while taking round, a registrar told his honorary, "Sir, this patient is of T.S." on hearing this comment, the patient was terribly disturbed. The patient who was not familiar with the medical term thought that the junior doctor was telling his professor that this patient is in its Terminal Stage (T.S.). In fact the patient was suffering from Tricuspid stenosis.
For a Holistic Health practioner the first and the easiest step is to address all patients preferably by their first name. Every person, however poor or rich, educated or uneducated, likes to hear his/her first name most frequently. The patient also identifies himself with the first name. When you call him by his first name, his mind will respond with a positive regard for you. And at the same time you are addressing his Holistic identity which includes body, mind and spirit.
Several busy medical practioner feel that they have got to see over hundred patients a day and it is very difficult to remember their names. After one of my lectures Dr. Shah told me, " Although I appreciate your suggestion, it is practically not possible to remember names of every patient." In fact it is a genuine difficulty for few busy doctors but yet one needs to put in efforts if one desires to treat patients Holistically. While studying medicine I have observed the miraculous effect of addressing patients by their first name. One of my Gynecologic professors while taking rounds always addressed patients by their first name. She used to say, Sujata, how are you feeling, Daksha is your health improving and so on. I observed that when the female patients were addressed by their first names there was a sign of happiness on their face. The patients waited eagerly for the doctor at the usual time of her round. The professor also taught us how to remember first names of many patients. She said "Most of the names are very common and as I have developed this practice I am easily able to remember them. I Try to associate names of new patients with the names of old patients, my relatives or people I know." This is a very easy technique. When you have to remember any new name try to link this new name with the name of the person whom you already know or an elite or well known person. If your patient's name is Dharmendra don't just memorize his name but think of another person with the same name whom you know. Next time when you meet this patient you will recollect the association which you had made. If your patient's name is Dhiraj' try to remember its meaning which means Patience'. In one particular case I wanted to remember the name of a Brahma Kumari Sister which I had difficulty in recalling. Her name was 'Surekha So once I thought Surekha' means a straight line. In this manner by understanding the meaning of this name I was easily able to remember her name. As quoted in some of the above examples, a little effort will help you to remember your patients name. Surely, for adapting this step of Holistic Health Care, doctors will have to put in these additional efforts. But these additional efforts will in turn give tremendous rewards in the form of a better doctor - patient relationship and rapid healing. If you are a family physician, remembering names of your patient is indeed vital, for those patients are going to visit you quite frequently and if you don't remember their names, the patients will tend to think that this doctor is not interested in me. Jitendra, my close friend was angry with Dr.Majumdar because even after several follow up visits every time Dr.Majumdar asked him What's your name?" Jitendra told me `I seriously doubt the ability of the doctor. IN spite of my several visits he is unable to remember my name. Then how can he remember all the medical information which is necessary for diagnosis and treatment. In spite of making efforts if you still are unable to remember the patients name, don't ask him his name. Instead ask him to give the past prescription or take out his old
records. Once you know his name, use it while taking his history or explaining your treatment. If you do this often it will help you to remember the patient's name. Dr.Majumdar who tends to forget the name of my friend Jitendra could have addressed him in the previous interview by asking, Jitendra, how do you feel now.? Jitendra I am giving you this medicine to be taken twice a day after your meals, and again at the end of the visit Jitendra you will definitely feel better, see me after 15 days." Addressing a patient by his first name during a visit has dual benefits. Firstly, the patient feels very happy on hearing his name. He starts developing faith in the doctor; Secondly, by repeating the patient's name you are able to impress it on your mind.
In subsequent visits as soon as the patient enters your chamber if you address him by his first name you have created a favorable mental attitude towards your treatment. To be a successful in your private practice this is a necessary positive step. This is most necessary in cities where there are many private doctors available and a patient can consult any other doctor if he/she is not happy with your approach and treatment.
